scholarly journals Polycystic Ovarian Syndrome: Clinical Features, Genetics of Disease, and Diagnosis Criteria

2021 ◽  
Author(s):  
Rashid Jafardoust Bostani ◽  
Maryam Parvini Kohneshahri
Keyword(s):  
Polycystic Ovary ◽  
Vital Role ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Sexual Hormones ◽  
Altered Expression ◽  
Wide Range ◽  
Invasive Method ◽  
Diagnosis Criteria ◽  
Type Two Diabetes

Introduction: The polycystic ovary syndrome (PCOS) is a complex endocrine condition affecting 7-10% of women in reproductive age. PCOS is generally characterized by hirsutism, hyperandrogenism, and polycystic ovaries. Insulin resistance is the hallmark of PCOS with a considerable prevalence. Despite numerous studies, the etiology of PCOS haas not been cleared yet; PCOS is considered a multifactorial syndrome with a wide range of genetic, endocrine, molecular, and environmental abnormalities. Altered expression of several genes and miRNAs in PCOS patients has become a useful and non-invasive method in the characterization of PCOS in the last decades. On the other hand, altered secretion of sexual hormones like testosterone, progesterone, and estrogen can be a valid confirmation of PCOS. Several methods and drugs are used to treat PCOS like anti-androgens, insulin sensitizers, and bariatric surgery. Conclusion: Taken together, PCOS is a common abnormality among women and not only does affect fertility, but also influences different aspects of their life from anxiety to type two diabetes. Women, especially in third world countries should care about their lifestyle and diet, which has a vital role in the prevention of PCOS. New methods in the diagnosis of PCOS lead to declining the side effects of PCOS.

Homeopathic Treatment in Patients with Polycystic Ovarian Syndrome: A Case Series

Homeopathy ◽  
2021 ◽  
Author(s):  
Suraia Parveen ◽  
Subhrasankha Das
Keyword(s):  
Side Effects ◽  
Polycystic Ovary ◽  
Causal Attribution ◽  
Case Series ◽  
Complementary Therapy ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Homeopathic Treatment ◽  
Ovulatory Dysfunction ◽  
Associated Symptoms

Abstract Background and Objectives Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder in women of reproductive age. It is characterized by various clinical presentations such as ovulatory dysfunction, polycystic ovaries, and hyperandrogenism. Considering the side effects associated with conventional treatment and the patients who fail to respond to these measures, there is a demand for a complementary therapy that would alleviate symptoms of PCOS without side effects. Homeopathy is a complementary system of medicine that has been successfully used in different disease conditions, including PCOS. A case series of PCOS is hereby presented, to demonstrate some positive results of individualized homeopathic treatment. Methods Seven cases of young women with PCOS were treated with individualized homeopathic medicines. Each case was followed up with clinical and ultrasonographic evidence and was reported according to the criteria set out in the HOM-CASE guidelines. The assessment of causal attribution of homeopathic treatment effect was carried out using the Modified Naranjo Criteria. Results Marked improvement was observed in all seven cases of PCOS. The irregular menstrual cycles and other associated symptoms became normal, along with a resolution of cysts in ovaries as evidenced by ultrasonography. All cases improved within 4 to 12 months of treatment. The Modified Naranjo Criteria total score was +9/13 for each case, which indicates a positive causal attribution of homeopathy in relieving the symptoms of PCOS. Conclusion This case series suggests a significant role of individualized homeopathic medicines in PCOS by regularizing the menstrual cycle along with the resolution of cysts and associated symptoms.

Case 11.1

2014 ◽  
pp. 531-532
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Endocrine Disorder ◽  
Secondary Amenorrhea ◽  
Increased Risk

28-year-old woman with secondary amenorrhea and hirsutism Axial fat-suppressed 2D SSFP images (Figure 11.1.1) demonstrate multiple follicles arranged in the periphery of the ovaries bilaterally. Polycystic ovary syndrome PCOS is the most common endocrine disorder in women of reproductive age, affecting between 6% and 15%, depending on the criteria used for diagnosis. It typically presents with anovulatory or oligo-ovulatory menstrual cycles leading to oligomenorrhea, polycystic ovaries, and clinical and biochemical hyperandrogenism. PCOS is also associated with increased risk of obesity, insulin resistance, diabetes mellitus, metabolic syndrome, and infertility....

scholarly journals Letrozole-Induced Polycystic Ovary Syndrome Attenuates Cystathionine-β Synthase Gene Expression in the Ovaries of Female Sprague Dawley Rats

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1244-1244
Author(s):  
Amanda Bries ◽  
Joe Webb ◽  
Brooke Vogel ◽  
Claudia Carrillo ◽  
Aileen Keating ◽  
...  
Keyword(s):  
Gene Expression ◽  
Polycystic Ovary Syndrome ◽  
Mrna Expression ◽  
Polycystic Ovary ◽  
Elevated Serum ◽  
Reproductive Age ◽  
Sprague Dawley ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Sd Rats

Abstract Objectives Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects 10% of reproductive age women and leads to hyperandrogenism, abnormal menstrual cycles, and polycystic ovaries. Moreover, PCOS has been associated with elevated serum homocysteine; however, the characterization of one-carbon metabolism (OCM) in PCOS remains incomplete. The aim of our research was to examine OCM in a genetic and chemically-induced rodent model of PCOS: 1) viable yellow Agouti (Avy) mice; and 2) letrozole (Let)-induced Sprague Dawley (SD) rats. Methods Five wk old female Avy mice (N = 18), their lean controls (N = 18), and SD rats (N = 36) were acclimated for one wk. Following acclimation, the animals were placed on a modified standard AIN93G diet (energy, %: 50.4, carbohydrate; 17.3, protein; and 32.3, fat). Rats were randomly assigned to Let (1 g/kg BW) treatment or vehicle (carboxymethylcellulose) control that was administered via a subcutaneously implanted slow-release pellet every 30-d. For both models, 12 animals were randomly assigned to be euthanized during proestrus at one of the following ages: 8, 16 or 24 wk. Bodyweight and estrous cycles were measured daily. Ovaries were collected to assess gene expression of OCM. These data were analyzed using linear mixed models to determine the main effects of age and treatment at a significance level of P < 0.05. Results Letrozole significantly reduced the occurrence of proestrus and estrus stages (P = 0.0001 and P = 0.006, respectively). Additionally, Let-induced rats had increased BW compared to control rats, across all age groups (P < 0.0001). In contrast, Avy mice weighed less than their controls by 24 wk of age (P < 0.0001). Cystathionine-β synthase (CBS) mRNA expression was downregulated in the Let-induced vs. control rats at 16 (59%; P < 0.05) and 24 (77%; P < 0.01) wk of age. As expected, Cyp19A1, aromatase mRNA was downregulated in the Let-induced rats (P = 0.02). Interestingly, betaine-homocysteine s-methyltransferase (BHMT) mRNA increased as a function of age in Let-induced rats (P = 0.03). Conclusions These data demonstrate that Letrozole-induced PCOS temporally decreases ovarian CBS mRNA expression; whereas, BHMT mRNA is upregulated as a function of age. Funding Sources This work was supported by the National Institute of Child Health and Human Development.

scholarly journals Impact of hypocaloric dietary intervention on ovulation in obese women with PCOS

Reproduction ◽  
2017 ◽  
Vol 153 (1) ◽  
pp. R15-R27 ◽  
Author(s):  
Brittany Y Jarrett ◽  
Marla E Lujan
Keyword(s):  
Weight Loss ◽  
Dietary Intervention ◽  
Polycystic Ovary ◽  
Reproductive Function ◽  
Antral Follicle ◽  
Reproductive Age ◽  
Obese Women ◽  
Dietary Interventions ◽  
Wide Range ◽  
The Impact

Polycystic ovary syndrome (PCOS) is a common cause of ovulatory dysfunction affecting women of reproductive age. Obesity and insulin resistance are thought to potentiate disruptions in antral follicle development that result in chronic anovulation, and as such, have become important therapeutic targets of dietary interventions aimed at weight loss. Caloric restriction has been shown to promote sporadic ovulation in obese women with PCOS, but improvements have occurred across a wide range of patients and little has been garnered about the factors that distinguish responders from non-responders. Further, few studies have evaluated the likelihood for modest weight loss to restore normal ovulatory cyclicity in PCOS. Consensus regarding the impact of dietary intervention on ovulation has been limited by variability in the measures used to characterize and report ovulatory status across studies. In response, this review provides an assessment of the evidence surrounding the effectiveness of hypocaloric dietary intervention to normalize ovulatory function in PCOS. The impact of physiological vs methodological factors on the evaluation of ovulatory status is discussed, and recommendations to strengthen future studies in this area are provided. Ultimately, further research is needed to understand the optimal dietary or lifestyle approaches that promote ovulation and sustained improvements in reproductive function in PCOS.

scholarly journals Update on polycystic ovary syndrome

2021 ◽  
Author(s):  
Jin Ju Kim
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Daily Practice ◽  
Antral Follicle ◽  
Reproductive Age ◽  
Lifestyle Modifications ◽  
First Line ◽  
Ovary Syndrome ◽  
Wide Range

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4–6 based on a lower percentile of 85%–90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

scholarly journals The role of polymorphism in various potential genes on polycystic ovary syndrome susceptibility and pathogenesis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Hiral Chaudhary ◽  
Jalpa Patel ◽  
Nayan K. Jain ◽  
Rushikesh Joshi
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Genetic Variants ◽  
Polycystic Ovary ◽  
Association Studies ◽  
Reproductive Age ◽  
Biosynthesis Pathway ◽  
Cytochrome P450 Enzymes ◽  
Adrenal Androgen ◽  
Ovary Syndrome ◽  
Altered Expression

AbstractPolycystic ovary syndrome (PCOS) is the most common endocrinopathies affecting the early reproductive age in women, whose pathophysiology perplexes many researchers till today. This syndrome is classically categorized by hyperandrogenism and/or hyperandrogenemia, menstrual and ovulatory dysfunction, bulky multi follicular ovaries on Ultrasonography (USG), and metabolic abnormalities such as hyperinsulinemia, dyslipidemia, obesity. The etiopathogenesis of PCOS is not fully elucidated, but it seems that the hypothalamus-pituitary-ovarian axis, ovarian, and/or adrenal androgen secretion may contribute to developing the syndrome. Infertility and poor reproductive health in women’s lives are highly associated with elevated levels of androgens. Studies with ovarian theca cells taken from PCOS women have demonstrated increased androgen production due to augmented ovarian steroidogenesis attributed to mainly altered expression of critical enzymes (Cytochrome P450 enzymes: CYP17, CYP21, CYP19, CYP11A) in the steroid hormone biosynthesis pathway. Despite the heterogeneity of PCOS, candidate gene studies are the widely used technique to delineate the genetic variants and analyze for the correlation of androgen biosynthesis pathway and those affecting the secretion or action of insulin with PCOS etiology. Linkage and association studies have predicted the relationship between genetic variants and PCOS risk among families or populations. Several genes have been proposed as playing a role in the etiopathogenesis of PCOS, and the presence of mutations and/or polymorphisms has been discovered, which suggests that PCOS has a vital heritable component. The following review summarizes the influence of polymorphisms in crucial genes of the steroidogenesis pathway leading to intraovarian hyperandrogenism which can result in PCOS.

Clinical profile of PCOS patients at a tertiary care center in Gandaki Province of Nepal

2020 ◽  
Vol 11 (5) ◽  
pp. 35-37
Author(s):  
Mahendra Raj Pandey
Keyword(s):  
Weight Gain ◽  
Rural Areas ◽  
Polycystic Ovary ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Medical Problems

Background: Polycystic Ovary Syndrome is one of the most common cause of anovulation in women of reproductive age, with a prevalence of upto 10%. Oligomenorrhea, hirsutism and obesity together with enlarged polycystic ovaries are the diagnostic criteria of PCOS. These women are vulnerable to type II diabetes, dyslipidemia, premature arteriosclerosis, and endometrial carcinoma. Aims and Objectives: The aim and objective of this study was to see the various clinical profile of PCOS patients at a Medical College in Nepal and to make patients aware about the long term sequalae associated with it. Materials and Methods: This was a retrospective study conducted in the outpatient department of Obstetrics and Gynaecology at Manipal Teaching Hospital from January 2018 till June 2019. A total of 90 patients presenting with oligomenorrhoea, obesity, acne, infertility and hirsutism were included in the study. The exclusion criteria were young women who had their menarche less than 2 years back, women older than 45 years, and patients on exogenous estrogen or progesterone therapy. Results: Out of 90 patients studied, 37(41%) were married and 53(59%) were unmarried. There were many patients from urban compared to rural areas (67% vs 33%). Many patients were either overweight (22%) or obese (61%) and 6% of the patients were underweight. Mean age at the time of presentation was 31.66 years with many patients (37%) between 30-35 years age group. Majority of the patients were either oligomenorrhoeic or amenorrhoeic (78 %). Weight gain was present in 83% of the patients. Infertility was present in 81% of the married patients. Fifteen women (17%) had hypothyroidism and were receiving treatment for the same. Ultrasonography was done in all the patients and typical necklace pattern of follicular arrangement was seen in 70 (78%) patients. Conclusion: The diagnosis of PCOS can be reliably predicted with the help of clinical features and sonography in women according to Rotterdam criteria. Oligomenorrhoea or amenorrhea and weight gain were main symptoms in our patients. It is important to educate and make unmarried PCOS patients aware of its association with infertility and long-term medical problems.

scholarly journals Controversies in the diagnosis of polycystic ovary syndrome

2020 ◽  
Vol 14 ◽  
pp. 263349412091303
Author(s):  
Preetham Rao ◽  
Priya Bhide
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Women Of Reproductive Age ◽  
Androgen Excess ◽  
Ovary Syndrome ◽  
Ultrasound Features

Polycystic ovary syndrome is a common endocrinological condition which is found to be prevalent in 5–10% of women of reproductive age. Historically, a combination of anovulation and androgen excess was considered a hallmark in the diagnosis of polycystic ovary syndrome. Addition of ultrasound features of polycystic ovary syndrome has improved the detection of variation in the polycystic ovary syndrome phenotype. Despite the widespread use of consensus diagnostic criteria, there remain several unresolved controversies in the diagnosis of polycystic ovary syndrome. Difficulty arises in methods of assessment and types of androgens to be measured to detect biochemical hyperandrogenism, setting a cut-off value for the diagnosis of clinical hyperandrogenism, setting an ultrasound threshold of antral follicle count to diagnose polycystic ovaries and also diagnosing this condition in adolescence where there is no clear definition for ‘irregular cycles’. This article looks at various controversies in the diagnosis of polycystic ovary syndrome.

COMPLICATIONS OF PREGNANCY IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

2011 ◽  
Vol 22 (3) ◽  
pp. 188-206
Author(s):  
MALLIKA AZIZIA ◽  
PAUL HARDIMAN
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Function ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Ovarian Syndrome

Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting around 5–8% of women of reproductive age. It has a variable clinical spectrum including hyperandrogenism, menstrual abnormalities, polycystic ovaries and metabolic features like diabetes mellitus, obesity and dyslipidaemia. The manifestation of PCOS and its impact especially on reproductive function and pregnancy are profoundly affected by associated features of obesity/raised body mass index and metabolic syndrome.

scholarly journals A Study on Physical and Physiological Impact of Polycystic Ovary Syndrome

2021 ◽  
Vol 69 (2) ◽  
Author(s):  
Sathish Kumar B.P ◽  
Dr. Sayantan Ghosh ◽  
Dr. Lipika Das ◽  
Dr. Aksa Merin Jose
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Healthy Lifestyle ◽  
Polycystic Ovary ◽  
Reproductive Organs ◽  
Reproductive Age ◽  
Therapeutic Interventions ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Metabolic Complications

Polycystic ovary syndrome is a relatively common hormonal disorder that causes a number of different symptoms in women of reproductive age. In such conditions, enlarged ovaries containing multiple small cysts (polycystic ovaries), are found. Although most women with PCOS have polycystic ovaries, some affected women do not. Common to all women with PCOS is an irregularity in menstrual cycle and the presence of excess male hormones (androgen). It disrupts the functioning of the reproductive organs that produce progesterone and estrogen, the hormones that regulate the menstrual cycle. A prospective observational study was carried out in 125 inpatients, after taking written informed consent from patients those who met the study criteria. A total of 125 patients were enrolled in the study, it was observed that 17.74% have experienced moderate depression, 18.54% patients experienced major irregular menstrual period problem, 2-25% of the patients were dealing with body weight, and 6.45% patients were identified that the growth of visible hair on the upper lip as a major problem. It was also found that 8.87% of patients experienced major menstrual cramps and patients were found worried about PCOS and hence disturbing their quality of life. Various long-term complication and co morbidities have been associated with PCOS and early diagnosed and therapeutic interventions are needed. PCOS is a chronic disease with manifestations across the life span and represents a major health and economic burden. Management should focus on support, education, addressing physiological factors and strongly emphasizing healthy lifestyle with targeted medical therapy as required. Addressing hyperandrogenism is clinically important and monitoring for and managing longer-term metabolic complications including dyslipidemia, IGT, DM2, cardiovascular risk factors, is crucial. Overall, further research is needed in this complex condition.

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